Caffeine is a risk factor for osteopenia of prematurity in preterm infants: a cohort study.
BMC Pediatr. 2018 Jan 22;18(1):9. doi: 10.1186/s12887-017-0978-6.
Ali E1,2, Rockman-Greenberg C3,4, Moffatt M5,3,4, Narvey M3,4, Reed M6, Jiang D5.
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Caffeine reduces Vitamin D Receptor, which reduces Vitamin D getting to cells
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- Rickets in half of premature births – 200 IU of vitamin D is enough – RCT May 2014
Study title = Prophylactic Effect of Low Dose Vitamin D in Osteopenia of Prematurity: A Clinical Trial Study
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Caffeine, the most commonly used medication in Neonatal Intensive Care Units, has calciuric and osteoclastogenic effects.
To examine the association between the cumulative dose and duration of therapy of caffeine and osteopenia of prematurity, a retrospective cohort study was conducted including premature infants less than 31 weeks and birth weight less than 1500 g. Osteopenia of prematurity was evaluated using chest X-rays on a biweekly basis over 12 weeks of hospitalization.
The cohort included 109 infants. 51% had osteopenia of prematurity and 8% had spontaneous rib fractures. Using the generalized linear mixed model, caffeine dose and duration of caffeine therapy showed a strong association with osteopenia of prematurity. Steroids and vitamin D were also significantly correlated with osteopenia of prematurity while diuretic use did not show a statistically significant effect.
The cumulative dose and duration of therapy of caffeine, as well as steroid are associated with osteopenia of prematurity in this cohort. Future studies are needed to confirm these findings and determine the lowest dose of caffeine needed to treat effectively apnea of prematurity.
PMID: 29357829 DOI: 10.1186/s12887-017-0978-6